Executive Leadership: Defining the Key Attributes of Leaders – a Practical Discussion on Change Management, Organizational Behavior, and Mentoring Attila J. Hertelendy, PhD, ACP Assistant Professor, Emergency Medicine Assistant Professor, Health Management Leadership & Policy Director, Emergency Health Services Program

Learning Objectives Analyze how leaders are developed in a changing dynamic environment Describe a new paradigm for leadership development applicable to ambulance service executives Articulate the importance of mentorship in Paramedicine and the need for continued research

Setting the stage The entire approach to the concept of healthcare provided by Paramedics requires LEADERSHIP. Paramedics have successfully demonstrated that they are capable of being stewards of their own profession. PARAMEDICS MUST CONTINUE TO LEAD. Many fundamental existential questions surrounding the identity of Parmedicine need to be resolved before we are able to develop a sustainable management model.

Ponder this throughout the discussion What are the skill sets required to lead effectively? How do you hone your skill sets to enable you to effectively lead in your organization? More importantly, how do you equip our future workforce to operationalize the changes and implement the vision for Emergency Care?

Assumptions It would be presumptuous to assume that the healthcare community has an accurate understanding of our knowledge, skills and abilities. Grant participants – need to be educated. Public Health, and other government agencies don’t really know what we can do.

Leading Change Healthcare is changing faster than many anticipated. EMS delivery systems must change to remain relevant. AACE is in the best position to lead change in and directly influence the way in which healthcare is delivered by Paramedics. – There are numerous positive catalysts for this change to occur.

Ponder this throughout the discussion Leadership development is an organization’s conscious effort to provide its managers and potential managers with opportunities to grow, learn, and change, in hopes of producing over the long term a cadre of managers with the skills necessary to function effectively in that organization. Question to consider are we doing this effectively in Paramedic Practice?

Leadership Development “Leadership and learning are indispensable to each other.” ~John F. Kennedy

Leadership is developed through: Experience Education Self-Awareness

Sources of Experience The two major developmental factors in any work situation are work associates and the task itself. Work associates can serve as positive or negative models. Work-related tasks give the leader an opportunity to become an effective and innovative problem solver.

Learning from Experience Amount of Challenge Variety of Tasks or Assignments Relevant Feedback

Broad Experience Broad Experience- Many aspects of leadership are situational. Gaining managerial experience in different settings is therefore advantageous. Multifunctional managerial development is an organization’s intentional efforts to enhance the effectiveness of managers by giving them experience in multiple organizational functions.

Leadership Development through Education and Training University Courses Leadership Training Programs

Education for Leaders How are we doing in this area? Why is this important? Is academic preparation required? If so what kind of academic preparation? What will we require of our future workforce in administrative settings?

Leadership &Management Education Management education is the acquisition of a broad range of conceptual knowledge and skills in formal classroom settings in degree-granting institutions Bachelor’s degree programs in EMS Management and Master’s Degree programs in EMS Leadership Executive education programs

Experiences at the George Washington University Developed an integrative Bachelor’s Degree completion program focused on EMS Management – Aligned with Competencies at the Entry Level – Middle Manager Developed a Master’s Degree in EMS Leadership – Focused on integration into the healthcare system – Aligned with Competencies at the Executive Level

Leadership &Management Development (cont.) Strategies used to develop managers include management education, management training, and on-the-job experiences. Management development activities account for approximately 30% of all funds budgeted for training by organizations.

Developmental Activities Multisource feedback Developmental assessment centers Developmental assignments Job rotation programs Action learning

Types of Leadership Development Programs Feedback-Intensive Programs Skill-Based Programs Conceptual Knowledge Programs Personal Growth Programs Socialization Programs Action Learning Programs Coaching and Psychotherapy

Continuum of Practical Options for Multifunctional Managerial Development

Self-Awareness Leadership Development Through Self-Awareness – An important mechanism underlying self-development is self-awareness, insightfully processing feedback about oneself to improve personal effectiveness. Self-awareness occurs at two levels. Single-loop learning occurs when learners seek minimum feedback that might substantially confront their basic ideas or actions. Single-loop learners think defensively. Double-loop learning is an in-depth type of learning that occurs when people use feedback to confront the validity of the goal or the values implicit in the situation.

Single-Loop Learning Single-loop learners seek relatively little feedback that may significantly confront their fundamental ideas or actions. – Individuals learn only about subjects within the “comfort zone” of their belief systems.

Double-Loop Learning Double-loop learning involves a willingness to confront one’s own views and an invitation to others to do so, too. – Openness to information and power sharing with others can lead to better recognition and definition of problems, improved communication, and increased decision-making effectiveness.

Single-Loop Learning Versus Double-Loop Learning

Self-Discipline Leadership Development Through Self-Discipline – Leadership development requires considerable self-discipline, mobilizing one’s effort and energy to stay focused on attaining an important goal. Self-discipline plays an important role in the continuous monitoring of one’s behavior to ensure that needed self- development occurs.

Self-Help Activities Develop a personal vision of career objectives. Seek appropriate mentors. Seek challenging assignments. Improve self-monitoring.

Self-Help Activities Seek relevant feedback. Learn from mistakes. Learn to view events from multiple perspectives. Be skeptical of easy answers.

Systems Perspective on Leadership Development Relationship Among Approaches Integrating Developmental Activities

Creating a Learning Climate ◦ Make job assignments that allow people to pursue their interests and learn new skills ◦ Establish work schedules that allow enough free time to try new methods ◦ Provide financial support for continuing education by employees ◦ Arrange special speakers and skills workshops for employees ◦ Establish a sabbatical program to allow employees to renew themselves

Creating a Learning Climate – Establish a career counseling program to help employees develop self-awareness and find ways to achieve their full potential – Establish voluntary skill assessment and feedback programs – Make pay increases partly dependent on skill development – Provide awards for innovations and improvements – Use symbols and slogans that embody values

Leadership Succession An orderly process of identifying and grooming people to replace managers Succession planning is linked to leadership development in two ways – Being groomed as a successor is part of leadership development – The process of choosing and fostering a successor is part of a manager’s own development

Developing a Pool of Successors Evaluate the extent of an organization’s pending leadership shortage Identify needed executive competencies Identify high-potential individuals for possible inclusion in the pool Establish an individually tailored developmental program for each potential candidate

Developing a Pool of Successors (cont’d) Select and place people into senior jobs based on their performance, experience, and potential Continuously monitor the program and give it top management support

Leadership Pipeline A model of leadership development that tightly links leadership development with management responsibilities at each level of the organization

Evaluation of Subordinates’ Efficacy as Crisis Leaders and In- Role Performance in Crisis Response Situations: The Role of Transformational Leadership and Mentoring Attila J. Hertelendy, PhD, Ethlyn Williams, PhD, Juanita Woods, PhD Candidate What do we know about mentoring in EMS Organizations?

Mentoring has been repeatedly supported through research as effective means of developing career efficacy and ability in proteges. (Allen, Eby, Poteet, Lentz, & Lima 2004; Scandura, Tejeda, Werther, & Lankau, 1996). Background

Transformational Leadership and Mentoring can independently strengthen ability and performance outcomes. Receipt of mentoring development can help the responder to internalize proper behaviors and enhance crisis response effectiveness (Sosik & Godshalk, 2000) Source of mentoring is understood in terms of supervisory career mentoring (SCM) - Direct supervisor of protégé. Vs. non supervisory mentoring. Background - Cont

Research have found that when supervisors act as mentors, the relationship between mentoring and career outcomes such as performance (Sandura & Williams, 2004), organizational commitment, and job satisfaction (Madlock & Kennedy- Lightsey, 2010) are stronger. Mentoring provided by a supervisor may be important for building positive career expectations within organizations. Background- Cont

Examined supervisory evaluations of crisis responders efficacy as leaders in crisis situations and crisis responders’ in role performance. Influence of transformational leadership and mentoring functions (careers and psychosocial) on crisis leader efficacy Current Research Study

Large EMS/ Fire Dept in South Eastern US 98 Crews participated in the study Of 156 members, reported on mentoring relationships Captain of each shift answered questions about the shift members (Firefighters and Paramedics) Each crew answered questions about work group, leadership and mentoring Methods

Results of regression analysis show 1. Transformational leadership and receipt of mentoring each have a statistically significant and positive association with supervisor evaluation of member crisis leader efficacy. Results

Only Transformational leadership has a statistically significant and positive association with team member in-role performance. These are initial preliminary results I wanted to share, data has not been fully analyzed and reported. National / International participation planned. Results

Mentoring Our experience is strengthened through mentoring.

MENTORING IS A LONG-TERM PROCESS THROUGH WHICH A SENIOR PERSON SUPPORTS THE PERSONAL AND PROFESSIONAL DEVELOPMENT OF A MORE JUNIOR COLLEAGUE. MENTORING RESULTS IN A MUTUALLY BENEFICIAL PROFESSIONAL RELATIONSHIP OVER TIME. Operational Definition

Business/Management Literature Harvard Business Review (Roche) 1,250 top Executives listed in the Wall Street Journal. 65% had at least one important mentor Mentored Execs had higher salaries, more rapid promotions, greater achievement of career objectives and higher job AND life satisfaction.

Outcomes for Protégés Better Job Performance More involvement in professional org’s More networking and job opportunities Greater satisfaction with institution Lower job attrition rates Stronger sense of professional identity Higher productivity Greater Career Eminence (Nobel Prize)

Benefits to Organizations Stronger long-term employee commitment Succession planning (future leaders) More impressive mentee performance Higher Retention Mentored employees more likely to mentor others in return

Mentoring and the Dead Obituaries of Eminent Psychologists 4 th most common theme in obituaries = “Inspirational Teacher/Mentor”

What Effective Mentoring Dyads Do

The Elements of Mentoring

Launch the Relationship with Care Expectations? What predicts early success? Clarify Ground Rules Set Boundaries Be alert to burnout

Know Thy Protégé Take Time with protégés. Be accessible and available. Identify protégé’s talents and strengths and communicate these insights clearly. Spend time discovering areas for further development.

Model Excellence In all professional domains: be congruent Model excellence. Reject perfectionism. Communicate confidence and high expectations.

Affirm, Affirm, Affirm Perhaps the “greatest” mentor function. Imposter Syndrome Be consistent & unconditional. Discern and affirm the “dream.” Gently shape and redirect unrealistic aspirations.

Early, explicit teaching may help. Demonstrate complex tasks. “Teaching moments.” Be a Teacher & Coach

Give the Inside Scoop Demystify the “System.” Give the political “lay of the land.” Avoid Gossiping or undermining colleagues.

Offer Counsel in Difficult Times Stand ready to Counsel. Don’t become a counselor. Offer warmth and kindness but practice the art of referral when needed.

Stimulate Growth: Challenge Deliberately challenge. Yerkes-Dodson Law When challenging, use the principle of titration. Exposure is the only answer to anxiety. Robin Williams

Self Disclose (When Appropriate) Disclose as a means of teaching, reassuring, and connecting. Who is benefiting? Offer a coping, not a mastery model.

Allow Increasing Mutuality Accept and encourage gradually increasing friendship. Increasing collegiality is validating for mentees. Respect preferences for hierarchical structure.

Narrate Growth and Development Point out milestones and successes. Help mentees step back and appreciate their progress.

Practice Humility & Patience Remain non- defensive and open to feedback. Nobody wants a “perfect” mentor… Humble mentors model fallibility w/o shame. Patience & EQ

Appreciate Development and Life Issues Second career mentees Very young mentees Real life transitions, challenges Personal and family life stress Financial challenges

Questions? Attila Hertelendy, PhD, ACP Tel: